Management of Ephedrine and Organophosphate Poisoning
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Questions and Answers

What is the preferred drug for managing ephedrine overdosage?

  • Atenolol
  • Labetalol (correct)
  • Carvedilol
  • Metoprolol

    • Which of the following is NOT a clinical feature of organophosphate poisoning?

  • Miosis
  • Tachycardia
  • Lacrimating
  • Hematoma (correct)

    • What is one of the first principles of management in an organophosphate poisoning scenario?

  • Neurological assessment
  • Decontamination (correct)
  • Immediate surgery
  • Psychological evaluation

    • Which of the following actions is part of reducing absorption in organophosphate poisoning management?

    <p>Gastric lavage</p> Signup and view all the answers

    Which anti-cholinergic drug is recommended for managing organophosphate poisoning?

    <p>Atropine sulphate</p> Signup and view all the answers

    What class of compounds does Ecothiophate belong to?

    <p>Organophosphates</p> Signup and view all the answers

    Which of the following symptoms indicates cholinergic crisis in organophosphate poisoning?

    <p>Diarrhea</p> Signup and view all the answers

    What role does activated charcoal play in the management of poisoning?

    <p>It assists in adsorption.</p> Signup and view all the answers

    What is the role of Pralidoxime in the treatment of organophosphate poisoning?

    <p>It reactivates Cholinesterase before aging occurs.</p> Signup and view all the answers

    Which of the following is true regarding the administration of Atropine in organophosphate poisoning?

    <p>Atropine can be repeated every 10-15 minutes until adequate atropinisation is achieved.</p> Signup and view all the answers

    What does the 'aging' of Cholinesterase refer to in the context of organophosphate exposure?

    <p>The irreversible formation of covalent bonds with organophosphate compounds.</p> Signup and view all the answers

    Which of the following parameters should be monitored during the treatment of organophosphate poisoning?

    <p>Heart rate, blood pressure, and lung fields.</p> Signup and view all the answers

    Why should Pralidoxime be given as soon as possible after organophosphate exposure?

    <p>To avoid the irreversible aging of Cholinesterase.</p> Signup and view all the answers

    How do organophosphate compounds affect acetylcholine levels in the nervous system?

    <p>By increasing acetylcholine levels in both peripheral and central nervous systems.</p> Signup and view all the answers

    What is the target systolic blood pressure (SBP) during treatment for organophosphate poisoning?

    <p>Above 90 mmHg.</p> Signup and view all the answers

    What physical examination finding is expected in a patient adequately treated for organophosphate poisoning?

    <p>Clear lung fields.</p> Signup and view all the answers

    What can excessive acetylcholine (ACh) in the central nervous system lead to?

    <p>CNS excitation or convulsions</p> Signup and view all the answers

    What is the role of cholinesterase testing in relation to organophosphate poisoning?

    <p>Reflect enzyme activity in neuronal synapse</p> Signup and view all the answers

    Which benzodiazepines are commonly used as anticonvulsants for treating convulsions in organophosphate poisoning?

    <p>Lorazepam and diazepam</p> Signup and view all the answers

    When is a patient typically observed for intermediate syndrome after organophosphate exposure?

    <p>24 to 96 hours</p> Signup and view all the answers

    What monitoring approach is NOT used for organophosphate poisoning?

    <p>Liver function tests</p> Signup and view all the answers

    Which symptom indicates rapid onset and severe progression in organophosphate poisoning?

    <p>Severe muscle weakness</p> Signup and view all the answers

    What condition may arise from excess acetylcholine leading to seizures?

    <p>Coma</p> Signup and view all the answers

    What should be monitored in patients who have been exposed to organophosphate poisoning?

    <p>Cholinesterase levels</p> Signup and view all the answers

    Study Notes

    Management of Ephedrine Overdosage

    • Gastric lavage and activated charcoal are used for managing ephedrine overdosage
    • Labetalol is the preferred medication for ephedrine overdosage management, while esmolol can be used as an alternative
    • Ephedrine overdosage can lead to increased heart rate and blood pressure

    Principles of Organophosphate Poisoning Management

    • Organophosphates inhibit acetylcholinesterase, leading to an accumulation of acetylcholine in the synapse
    • ToXIL was used to treat glacuna
    • Organophosphates are categorized as pesticides and nerve agents, with examples including Ecothiophate, Parathion, Malathion, Tabun, Sarin, and Soman

    Clinical Features of Organophosphate Poisoning

    • Organophosphate poisoning results in muscarinic and nicotinic effects
    • Muscarinic effects include diarrhea, urination, miosis, bradycardia, bronchospasm, emesis, lacrimation, and salivation
    • Nicotinic effects include mydriasis, tachypnea, weakness, tachycardia, muscle fasciculations, and muscle weakness

    Organophosphate Poisoning Management

    • ABCD approach: Airway, Breathing, Circulation, Decontamination/Drugs
    • Decontamination/Drugs:
      • Prevent/reduce absorption: Wash skin, eyes, and hair with soap and water, remove contaminated clothing, gastric lavage
      • Anti-muscarinic drug: Atropine sulfate (2-3mg IV stat and monitor every 10-15 minutes)
      • Cholinesterase reactivators: Pralidoxime (immediate administration)
      • Anticonvulsants: Benzodiazepines (lorazepam, diazepam) for seizures or coma

    Cholinesterase Reactivators

    • Pralidoxime reactivates the cholinesterase enzyme that is inhibited by organophosphates
    • Pralidoxime should be administered before the enzyme ages, as aging makes the enzyme less responsive to reactivation
    • Aging refers to the irreversible formation of covalent bonds between the organophosphate compound and acetylcholinesterase

    Anti-Cholinergic Drug Monitoring

    • Target goals:
      • Systolic blood pressure (SBP) > 90 mmHg
      • Heart rate > 110/minute
      • Clear lung fields
      • Pupils in mid position
      • Bowel sounds present

    Acetylcholine in the Central Nervous System

    • Organophosphate compounds can easily cross the blood-brain barrier due to their lipophilicity
    • Excess acetylcholine in the brain can result in convulsions or coma

    Laboratory Tests for Monitoring

    • Plasma cholinesterase: Synthesized by the liver, not used for monitoring OP poisoning
    • Red blood cell (RBC) cholinesterase: More accurately reflects the enzyme in the neuronal synapse, used for monitoring OP poisoning

    Intermediate Syndrome

    • Intermediate syndrome can occur 24-96 hours after OP exposure
    • Characterized by rapid onset of severe muscle weakness that progresses over 4 days
    • Patients should be monitored for the first 4 days after OP exposure

    Discharge Criteria

    • Patients can be discharged from the hospital when they are stable and symptoms have resolved.
    • The decision to discharge should be made by a physician and should be based on clinical criteria.

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    Management of Ephedrine Overdosage PDF

    Description

    This quiz covers the management strategies for ephedrine overdosage and the clinical features of organophosphate poisoning. It highlights the use of gastric lavage and medications like labetalol for ephedrine overdose, as well as the effects and treatment of organophosphate poisoning. Test your knowledge on these critical clinical scenarios.

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